Provider Demographics
NPI:1154992907
Name:MCMAHON, WHITNEY TAMERA (FNP-C)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:TAMERA
Last Name:MCMAHON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5025 COHUTTA VARNELL RD
Mailing Address - Street 2:
Mailing Address - City:COHUTTA
Mailing Address - State:GA
Mailing Address - Zip Code:30710-9591
Mailing Address - Country:US
Mailing Address - Phone:706-463-5269
Mailing Address - Fax:
Practice Address - Street 1:1001 MARKET ST STE 16
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-5096
Practice Address - Country:US
Practice Address - Phone:706-980-3559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-02
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN205463363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty